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The Swedish organization in charge of reviewing research has judged that scandal-hit surgeon was guilty of scientific misconduct for misleadingly describing synthetic trachea operations as successful in a series of research articles. In 2014, four doctors at Stockholm's Karolinska University Hospital reported him to the then president of the Karolinska Institute (KI) for allegedly distorting the facts about his operations with artificial tracheas when presenting them in scientific journals. The articles were subsequently reviewed in 2015 by Uppsala University surgical sciences professor, who concluded that Macchiarini was guilty of research misconduct, but KI's overall assessment was to clear him and the co-authors.

In an analysis carried out jointly by the Publications Ethics Committee and the International Association of Scientific, Technical and Medical Publishers, over half of the 3,440 articles submitted over a two-year period were found to be fake. Open science practices, such as pre-registration of study plans and registered reports could promote transparency and accountability. Recognizing the importance of peer review and rewarding reviewers can also strengthen academic integrity and reduce the proliferation of suspect articles.